OBJECTIVES: Most common cause of admission in Neonatal intensive care unit (NICU) is respiratory distress. There are many causes of respiratory distress, among them, transient tachypnoea of newborn, respiratory distress syndrome, meconium aspiration syndrome, perinatal asphyxia and sepsis are the commonest causes. The aim of this study was to identify the etiology of neonates admitted with respiratory distress in tertiary level hospital and also to study the immediate outcome of these babies.

 METHODS: A retrospective study was conducted in level II and level III NICU in Department of Neonatology, Niloufer Hospital. Both Inborn and Outborn neonates presenting with respiratory distress were included in the study. Data was collected from all patients’ records, admitted during the period from January to June 2016. SPSS software was used to formulate the results.

RESULTS: A total of 854 patients were admitted, among them 393 cases were due to respiratory distress (46 %). There was male predominance (55 %).  Majority of cases were outborn (72.2%).Babies born preterm were 81%. The commonest cause of respiratory distress in our study was respiratory distress syndrome followed by meconium aspiration syndrome and transient tachypnea of newborn. Assisted ventilation was required by 59.7 % of cases. Overall mortality rate was 23.4 %. Most common cause of mortality was RDS followed by meconium aspiration syndrome and pneumonia.

CONCLUSION: Antenatal steroids should be administered to the eligible mothers at all levels of health care to decrease the mortality and morbidity of preterms. Early in–utero referral of high risk mothers to tertiary care centre should be advocated. Infrastructure and human resources in government setup should be strengthened to provide assisted ventilation to the babies.